Literature DB >> 21142849

Clinical improvement after treatment provided through the Better Outcomes in Mental Health Care (BOiMHC) programme: do some patients show greater improvement than others?

Jane Pirkis1, Bridget Bassilios, Justine Fletcher, Kristy Sanderson, Matthew J Spittal, Kylie King, Fay Kohn, Philip Burgess, Grant Blashki.   

Abstract

OBJECTIVE: Australia's Better Outcomes in Mental Health Care (BOiMHC) programme enables GPs to refer patients with common mental disorders to allied health professionals for time-limited treatment, through its Access to Allied Psychological Services (ATAPS) projects. This paper considers whether patients who receive care through the ATAPS projects make clinical gains, if so, whether particular patient-related and treatment-related variables are predictive of these outcomes.
METHOD: Divisions of General Practice (Divisions), which run the ATAPS projects, are required to enter de-identified data into a minimum dataset, including data on patients' socio-demographic and clinical characteristics, the sessions of care they receive, and their clinical outcomes. We extracted data from January 2006 to June 2010, and examined the difference between mean pre- and post-treatment scores on the range of outcome measures being used by Divisions. We then conducted a linear regression analysis using scores on the most commonly-used outcome measure as the outcome of interest.
RESULTS: Pre- and post-treatment outcome data were available for 16 700 patients from nine different outcome measures. Across all measures, the mean difference was statistically significant and indicative of clinical improvement. The most commonly-used measure was the Kessler-10 (K-10), and pre- and post-treatment K-10 data were available for 7747 patients. After adjusting for clustering by Division, outcome on the K-10 was associated with age, levels of income and education, previous receipt of mental health care, number of sessions, treatment received and pre-treatment K-10 score. The benchmark was sufficiently high, however, that even the groups that fared relatively less well still showed strong improvement in absolute terms.
CONCLUSIONS: Patients who receive care through the ATAPS projects are making considerable clinical gains. A range of socio-demographic, clinical and treatment-based variables are associated with the levels of outcomes achieved, but improvements are still substantial even for those in the relatively disadvantaged groups.

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Year:  2010        PMID: 21142849     DOI: 10.3109/00048674.2010.539195

Source DB:  PubMed          Journal:  Aust N Z J Psychiatry        ISSN: 0004-8674            Impact factor:   5.744


  6 in total

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Journal:  Implement Sci       Date:  2012-01-16       Impact factor: 7.327

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Journal:  Int J Ment Health Syst       Date:  2017-02-10

5.  Enhanced primary mental healthcare for Indigenous Australians: service implementation strategies and perspectives of providers.

Authors:  Lennart Reifels; Angela Nicholas; Justine Fletcher; Bridget Bassilios; Kylie King; Shaun Ewen; Jane Pirkis
Journal:  Glob Health Res Policy       Date:  2018-06-04

6.  Referral patterns to primary mental health services in Western Sydney (Australia): an analysis of routinely collected data (2005-2018).

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